Evidence map›Paper›PMID 40337953›Full record

SynthesisActa orthopaedica et traumatologica turcica2025

The effectiveness of arthroscopic irrigation and debridement in the management of septic arthritis following anterior cruciate ligament reconstruction: A Systematic Review and Meta-Analysis.

Edi Mustamsir, Aji Aulia Pandu, Alexander Fernando

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Acta orthopaedica et traumatologica turcica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Infection Following ACL Reconstruction: From Prevention to Treatment.The archives of bone and joint surgery · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Edi MustamsirDepartment of Orthopaedic and Traumatology, Brawijaya University Faculty of Medicine, Saiful Anwar State General Hospital, Malang, Indonesia.
Aji Aulia PanduBrawijaya University Faculty of Medicine, Malang, Indonesia.
Alexander FernandoBrawijaya University Faculty of Medicine, Malang, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This meta-analysis aimed to evaluate the e!ectiveness of arthroscopic irrigation and debridement in the management of septic arthritis following anterior cruciate ligament reconstruction (ACL-R), with a focus on graft retention rates, functional outcomes, and the microbiological profile of infections. Methods: This meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024562550). PubMed, Cochrane, ProQuest, and ScienceDirect databases were searched for studies published before July 2024 using predefined Medical Subject Headings terms and keywords related to ACL-R infections and arthroscopic irrigation and debridement. Inclusion criteria followed the PICO framework: Population (patients with septic arthritis following ACL-R), intervention (arthroscopic irrigation and debridement), comparator (none), and outcomes (graft retention rate, Lysholm Knee Score, International Knee Documentation Committee [IKD] score, and Tegner Activity Scale [TAS], and microbiology data). The risk of bias was assessed using the Cochrane Risk of Bias in Non-Randomized Studies-of Interventions. Meta-analyses were performed using R Studio, with results presented as pooled proportions or means with 95% confidence intervals (95% CI). Results: A total of 20 studies involving 333 patients were analyzed, with follow-up periods ranging from 18 days to 67 months. The pooled graft retention rate was 92% (95% CI [88-94%]), confirmed by proportional meta-analysis with low heterogeneity (I"=0%, P=2.0948). Functional knee outcomes showed pooled mean scores of 82.41 for Lysholm (95% CI [78.15-86.66], I"=87.3%-92.7%), 79.37 for IKDC (95% CI [74.00-84.75], I"=68.3%-82.2%), and 5.08 for TAS (95% CI [4.87-5.30], I"=0%-52.6%), indicating moderate to satisfactory recovery. Coagulase-negative Staphylococcus (42.34%) and Staphylococcus aureus (23.12%) were the most frequently isolated pathogens, with 9.91% of cases involving antibiotic-resistant strains, including MRSA (4.50%) and MR-CNS (5.41%). Cephalosporin or vancomycin was the most commonly administered first-line antibiotic, often combined with other agents. Conclusion: The findings suggest that arthroscopic irrigation and debridement, combined with appropriate antibiotic therapy, are e!ective in managing septic arthritis following ACL-R, achieving a high graft retention rate of 92% and moderate to satisfactory functional outcomes. However, the presence of antibiotic-resistant pathogens and challenges in returning to high-level sports highlight the importance of preventive measures to protect athlete performance and recovery. Level of Evidence: Level IV, Therapeutic Study.

Indexed as

Anterior Cruciate Ligament ReconstructionArthritis, InfectiousArthroscopyDebridementPostoperative ComplicationsTherapeutic IrrigationHumansTreatment OutcomeACL reconstruction infectionArthroscopic debridementFunctional knee outcomesGraft retentionMicrobiological profile

Identifiers

PMID40337953
PMCPMC11992927

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.